Despite the integration of telephone and VDU technologies, call centres are not uniform in terms of work organization. It is suggested that diversity can best be understood by reference to a range of quantitative and qualitative characteristics. Consequently, perspectives that treat all call centres as if they were the same hybrids of customization and routinization are rejected, along with over-optimistic interpretations of labour control over work organization. Empirical evidence from nine `workflows' in two call centres - an established financial sector organization and a rapidly growing outsourced operation - provide excellent grounds for an examination of similarity and difference. A picture emerges of workflows which are volume-driven and routinized, involving low levels of employee discretion, and, by contrast, those less dominated by quantitative criteria offering higher levels of operator discretion and an emphasis on the quality of customer service. Despite these distinctions, larger numbers of operators report an experience of work which is driven by quantitative imperatives, most manifest in the pervasive implementation of targets. Targets are also used increasingly to assess and mould the quality of the call centre operator's interaction with the customer. Overall, the evidence casts doubt on the optimistic perspective that call centre work, in time, will come to resemble `knowledge work'.
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The paper evaluates the centrality of work to employees in two growing employment sectors, call-centres and software development. It then examines evidence for extensions of work into household and family life in these two sectors. Extensions are identified as tangible, such as unpaid overtime, or intangible, represented by incursions imported from work, such as exhaustion and stress. The study finds that organizational pressures, combined with lack of work centrality, result in work intruding into non-work areas of employee lives, though intrusions manifest themselves in different ways according to type of work, levels of worker autonomy and organizational support. Copyright Blackwell Publishing Ltd/London School of Economics 2003..
Given the widespread introduction of empowerment within the UK, this article examines meanings of the concept and the implementation of specific initiatives. From a study of thirteen organisations it is suggested empowerment has limitations and tensions including little power dissemination, close control over employees, poor prospects of extra remuneration and job insecurity.
Physician assistants (PAs) have medical training and work supervised by a doctor. In 2006-2008 the Scottish Government piloted use of USA-trained PAs. The aim of the paper is to evaluate the impact and contribution made by PAs to delivering effective health care in National Health Service (NHS) Scotland. Mixed methods, longitudinally, including interviews, feedback forms and activity data collection. Data analysis used nVivo, SPSS and Excel. Participants were 15 USA-trained PAs, medical supervisors and team members, 20 patients, four NHS senior managers and three trade union representatives. Settings were four Scottish NHS Boards where PAs worked in primary care, out of hours clinics, emergency medicine, intermediate care and orthopaedics. Two minor patient safety issues arose. Patients were satisfied with PAs. Scope of practice did not replicate US working. Inability to prescribe was a hindrance. PAs tended to have longer consultations, but provided continuity and an educational resource. They were assessed to be mid-level practitioners approximating to nurse practitioner or generalist doctor. Valued features were generalism, medical background, confidence differential diagnosis and communication. Interviewees suggested PAs could fulfil roles currently filled by medical staff, potentially saving resources. In conclusion, there is potential for PAs to fulfil distinctive mid-level roles in the Scottish NHS adding value in continuity, communication and medical approach.
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